Fortification of maize flour and corn meal
Fortification is the practice of deliberately increasing the content of an essential micronutrient, i.e. vitamins and minerals (including trace elements) in a food, so as to improve the nutritional quality of the food supply and provide a public health benefit with minimal risk to health.
Maize, also referred to as corn, is cultivated in most parts of the world, as it grows in diverse climates. Maize is an important cereal crop and together with wheat and rice account for 94% of total cereal consumption worldwide.
Industrial fortification of maize flour and corn meal with at least iron has been practised for many years in several countries in the Americas and Africa, where these ingredients are used in the preparation of many common national dishes. When appropriately implemented, fortification is an efficient, simple and inexpensive strategy for supplying vitamins and minerals to the diets of large segments of the population.
WHO recommendations
Fortification of maize flour and corn meal with iron is recommended to prevent iron deficiency in populations, particularly vulnerable groups such as children and women.
Fortification of maize flour and corn meal with folic acid is recommended to reduce the risk of occurrence of births with neural tube defects.
Additional information, including a suggested scheme for fortification, can be found in the guidance summary, and in the guidance documents under 'WHO documents' below.
WHO documents
GRC-approved guidelines
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Fortification of maize flour and corn meal with vitamins and minerals
Publication date: 2016
Other guidance documents
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Recommendations on wheat and maize flour fortification meeting report: interim consensus statement
Publication date: 2009 -
Guidelines on food fortification with micronutrients
Publication date: 2006
Evidence
Systematic reviews used to develop the guidelines
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Fortification of maize flour with iron for preventing anaemia and iron deficiency in populations (protocol)
Pasricha SR, De-Regil LM, Garcia-Casal MN, Burford BJ, Gwirtz JA, Peña-Rosas JP.
Cochrane Database of Systematic Reviews. 2012; Issue 11. Art. No.: CD010187.
(Review has been submitted for publication) -
Fortification of wheat and maize flour with folic acid for population health outcomes (protocol)
De-Regil LM, Finkelstein JL, Sæterdal I, Gaitán D, Peña-Rosas JP.
Cochrane Database of Systematic Reviews. 2016; Issue 4. Art. No.: CD012150.
(Review has been submitted for publication) -
Effect of iron-fortified foods on hematologic and biological outcomes: systematic review of randomized controlled trials
Gera T, Sachdev H, Boy E.
Am J Clin Nutr. 2012;96:309–24. -
Global birth prevalence of spina bifida by folic acid fortification status: a systematic review and meta-analysis
Atta CA, Fiest KM, Frolkis AD, Jette N, Pringsheim T, St Germaine-Smith C et al.
Am J Public Health. 2016;106:e24–34. -
Fortification of staple foods with vitamin A for preventing vitamin A deficiency
Hombali AS, Venkatesh BT, Nair S, Peña-Rosas JP.
Cochrane Database of Systematic Reviews. 2012; Issue 9. Art. No.: CD010068.
(Update has been submitted for publication) -
Fortification of staple foods with zinc for improving zinc status and other health outcomes in the general population
Shah D, Sachdev HS, Gera T, De-Regil LM, Peña-Rosas JP.
Cochrane Database of Systematic Reviews. 2016; Issue 6. Art. No.: CD010697. -
Food fortification with calcium and vitamin D: impact on health outcomes
Das JK, Salam RA, Lassi ZS, Bhutta ZA.
Cochrane Database of Systematic Reviews. 2012; Issue 11. Art. No.: CD010201. -
Micronutrient fortification of food and its impact on woman and child health: a systematic review
Das JK, Salam RA, Kumar R, Bhutta ZA.
Syst Rev 2013;2:67–93.
Other related systematic reviews
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Evidence of the effectiveness of flour fortification programs on iron status and anemia: a systematic review
Pachón H, Spohrer R, Mei Z, Serdula MK.
Nutrition Reviews. 2015; 73(11):780-95.